My five year old daughter was diagnosed as HIV positive when she was nearly two (she may have been infected at birth, or by a subsequent blood-transfusion; she is adopted and we will never know the answer to this question). Since then her viral load has stayed in the 3,000 to 4,000 range and her CD4% has fluctuated between 27% and 31%. At her last 3 month check-up she had a viral load of 3,222 and CD4 of 883 and CD4% of 30%. On the advice of her doctors she is not yet on meds. She is healthy and active and shows no effects of the disease. While I am happy to have her off meds, especially since she is so young and will face decades of them in the future, I don't want to be foolish about her treatment. Would you agree that holding off on meds until her viral load is above 50,000 or her CD4% drops below 25% is the right course of action? I have heard about HIV causing irreversible dementia--how likely is that at these levels?

Given the healthy CD4% and low viral load I would likely agree with her doctors.